Cancer Research and Treatment

Original Articles

Trends and Outcomes of Lung Cancer Surgery in South Korea: Joon Beom Park, Su-Jin Cho, Myung-Il Hahm, Danbee Kang, Seong Yong Park; Received March 14, 2025 Accepted May 24, 2025 Published online May 27, 2025; DOI: https://doi.org/10.4143/crt.2025.295 [Epub ahead of print]

Abstract PDF Supplementary Material: Purpose
This study analyzed nationwide trends in lung cancer surgery in South Korea over 14 years, focusing on surgical volume, patient demographics, surgical approaches, and outcomes.
Materials and Methods
We performed a retrospective cohort study using nationwide health insurance claims data (124,334 cases) and robotic surgery data (1,740 cases) provided by the manufacturer. Patients who underwent lung cancer surgery between 2010 and 2023 were included. Annual trends were assessed using the annual percentage change (APC), and logistic as well as linear regression models were used to identify predictors of mortality and prolonged hospital stay.
Results
The annual surgical volume increased from 4,557 in 2010 to 14,184 in 2023 (APC, 8.86%; p < 0.001). Video-assisted thoracoscopic surgery (VATS) became the predominant approach, rising from 52.9% to 94.8% (APC, 4.11%; p < 0.001). Sub-lobar resections increased, with wedge resections growing from 9.0% to 18.5% (APC, 5.72%; p < 0.001) and segmentectomies from 3.0% to 17.9% (APC, 14.63%; p < 0.001). The proportion of female patients increased from 32.0% to 44.7% (APC, 2.39%; p < 0.001), while patients aged 70-79 years increased from 26.3% to 32.3% (APC, 1.60%; p < 0.001) and those aged ≥ 80 years from 2.0% to 6.2% (APC, 9.63%; p < 0.001). The median hospital stay decreased from 13 to 7 days (APC, –4.34%; p < 0.001), and 30-day mortality declined from 2.45% to 0.76% (APC, –8.32%; p < 0.001).
Conclusion
Lung cancer surgery in Korea has increased substantially, with a notable shift toward minimally invasive and lung-sparing techniques that have improved outcomes. However, persistent disparities underscore the need for a national surgical registry.

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Breast cancer

Impact of Social Support during Diagnosis and Treatment on Disease Progression in Young Patients with Breast Cancer: A Prospective Cohort Study: Danbee Kang, Seri Park, Hyo Jung Kim, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Se Kyung Lee, Ji-Yeon Kim, Seok Jin Nam, Juhee Cho, Yeon Hee Park; Cancer Res Treat. 2024;56(1):125-133. Published online September 4, 2023; DOI: https://doi.org/10.4143/crt.2023.673

Abstract PDF PubReader ePub: Purpose
We evaluated the association between changes in social support after cancer treatment and recurrence-free survival (RFS) in such patients using a prospective cohort study.
Materials and Methods
Data were obtained from a prospective cohort study (NCT03131089) conducted at Samsung Medical Center (2013-2021). The primary outcome measure was RFS. Social support was measured using the social and family well-being (SFWB) domain of the Functional Assessment of Cancer Therapy-General. We calculated the changes in SFWB scores before and during treatment and the hazard ratio for RFS by comparing such changes.
Results
The mean±standard deviation (SD) age of the patients was 35±3.9 years, and 71.5% and 64.8% of the patients were married and had children, respectively. The mean±SD SFWB score at baseline was 20.5±5.0 out of 26. After cancer treatment, 35.9%, 10.3%, and 53.8% of the participants had increasing, unchanged, and decreasing SFWB scores, respectively. The decreasing SFWB score group had a higher risk of mortality or recurrence than the increasing group. Risk factors for the decreasing score were the presence of children during diagnosis.
Conclusion
In this cohort, changes in social support after treatment were associated with RFS in young patients with breast cancer. Health professionals should develop family interventions to help them receive proper social support.

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General

Effectiveness of Self-Assessment, TAilored Information, and Lifestyle Management for Cancer Patients’ Returning to Work (START): A Multi-center, Randomized Controlled Trial: Danbee Kang, Ka Ryeong Bae, Yeojin Ahn, Nayeon Kim, Seok Jin Nam, Jeong Eon Lee, Se Kyung Lee, Young Mog Shim, Dong Hyun Sinn, Seung Yeop Oh, Mison Chun, Jaesung Heo, Juhee Cho; Cancer Res Treat. 2023;55(2):419-428. Published online November 8, 2022; DOI: https://doi.org/10.4143/crt.2022.939

Abstract PDF Supplementary Material PubReader ePub

Purpose
We developed a comprehensive return to work (RTW) intervention covering physical, psycho-social and practical issues for patients newly diagnosed and evaluated its efficacy in terms of RTW.
Materials and Methods
A multi-center randomized controlled trial was done to evaluate the efficacy of the intervention conducted at two university-based cancer centers in Korea. The intervention program comprised educational material at diagnosis, a face-to-face educational session at completion of active treatment, and three individualized telephone counseling sessions. The control group received other education at enrollment.
Results
At 1-month post-intervention (T2), the intervention group was more likely to be working compared to the control group after controlling working status at diagnosis (65.4% vs. 55.9%, p=0.037). Among patients who did not work at baseline, the intervention group was 1.99-times more likely to be working at T2. The mean of knowledge score was higher in the intervention group compared to the control group (7.4 vs. 6.8, p=0.029). At the 1-year follow-up, the intervention group was 65% (95% confidence interval, 0.78 to 3.48) more likely to have higher odds for having work.
Conclusion
The intervention improved work-related knowledge and was effective in facilitating cancer patients’ RTW.

Citations

Citations to this article as recorded by

Psychosocial Adjustment Experiences Among Nasopharyngeal Carcinoma Survivors
Jie Jiang, Ming-Hui Yan, Yu-Ying Fan, Jun-E Zhang
Cancer Nursing.2025; 48(4): E230. CrossRef
Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial
Wonyoung Jung, Alice Ahn, Genehee Lee, Sunga Kong, Danbee Kang, Dongok Lee, Tae Eun Kim, Young Mog Shim, Hong Kwan Kim, Jongho Cho, Juhee Cho, Dong Wook Shin
JMIR Research Protocols.2024; 13: e54707. CrossRef
A visualized and bibliometric analysis of cancer vocational rehabilitation research using CiteSpace
Zebing Luo, Xuejia Liu, Chujun Chen
Work.2024; : 1. CrossRef

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Lung and Thoracic cancer

Psychometric Validation of the Korean Version of the Cancer Survivors’ Unmet Needs (CaSUN) Scale among Korean Non–Small Cell Lung Cancer Survivors: Danbee Kang, Genehee Lee, Sooyeon Kim, Heesu Nam, Sunga Kong, Sungkeun Shim, Jae Kyung Lee, Wonyoung Jung, Sumin Shin, Hong Kwan Kim, Jae Ill Zo, Young Mog Shim, Dong Wook Shin, Juhee Cho; Cancer Res Treat. 2023;55(1):61-72. Published online February 23, 2022; DOI: https://doi.org/10.4143/crt.2021.1583

Abstract PDF PubReader ePub

Purpose
The purpose of the study was to validate the Korean version of Cancer Survivors’ Unmet Needs (CaSUN) scale among non–small cell lung cancer survivors.
Materials and Methods
Participants were recruited from outpatient clinics at the Samsung Medical Center in Seoul, South Korea, from January to October 2020. Participants completed a survey questionnaire that included the CaSUN. Exploratory and confirmatory factor analysis and Pearson’s correlations were used to evaluate the reliability and validity of the Korean version of the CaSUN (CaSUN-K). We also tested known-group validity using an independent t test or ANOVA.
Results
In total, 949 provided informed consent and all of which completed the questionnaire. Among the 949 patients, 529 (55.7%) were male; the mean age and median time since the end of active treatment (standard deviation) was 63.4±8.8 years and the median was 18 months. Although the factor loadings were different from those for the original scale, the Cronbach’s alpha coefficients of the six domains in the CaSUN-K ranged from 0.68 to 0.95, indicating satisfactory internal consistency. In the CFA, the goodness-of-fit indices for the CaSUN-K were high. Moderate correlations demonstrated the convergent validity of CaSUN-K with the relevant questionnaire. More than 60% of the participants reported information-related unmet needs, and the CaSUN-K discriminated between the needs reported by the different subgroups that we analyzed.
Conclusion
The CaSUN-K is a reliable and valid measure for assessing the unmet needs in a cancer population, thus this tool help population to receive timely, targeted, and relevant care.

Citations

Citations to this article as recorded by

Unmet needs among long-term breast cancer survivors
Rina A. Yarosh, Hazel B. Nichols, Rachel Hirschey, Erin E. Kent, Deborah K. Mayer, Melissa A. Troester, Eboneé N. Butler
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Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial
Wonyoung Jung, Alice Ahn, Genehee Lee, Sunga Kong, Danbee Kang, Dongok Lee, Tae Eun Kim, Young Mog Shim, Hong Kwan Kim, Jongho Cho, Juhee Cho, Dong Wook Shin
JMIR Research Protocols.2024; 13: e54707. CrossRef
Validity and Reliability of a Simplified Chinese Version of Cancer Survivors' Unmet Needs Scale (CaSUN)
Xiaojingyuan Xu, Xiaoyun Liang, Shiquan Yin
Psycho-Oncology.2024;[Epub] CrossRef
Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea
Junhee Park, Wonyoung Jung, Genehee Lee, Danbee Kang, Young Mog Shim, Hong Kwan Kim, Ansuk Jeong, Juhee Cho, Dong Wook Shin
Healthcare.2023; 11(14): 2012. CrossRef
Kanserden Kurtulanların Karşılanmayan İhtiyaçları Ölçeğinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması
Gülyeter Erdoğan Yüce, Gamze Muz, Ayser Döner
Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi.2023; 10(3): 264. CrossRef
Psychometric properties of the Slovenian version of the Cancer Survivors’ Unmet Needs (CaSUN-SL) measure in post-treatment cancer survivors
Špela Miroševič, Polona Selič-Zupančič, Judith Prins, Vesna Homar, Zalika Klemenc-Ketiš
BMC Psychology.2022;[Epub] CrossRef

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Breast cancer

Fear of Cancer Recurrence and Its Negative Impact on Health-Related Quality of Life in Long-term Breast Cancer Survivors: Thi Xuan Mai Tran, So-Youn Jung, Eun-Gyeong Lee, Heeyoun Cho, Na Yeon Kim, Sungkeun Shim, Ho Young Kim, Danbee Kang, Juhee Cho, Eunsook Lee, Yoon Jung Chang, Hyunsoon Cho; Cancer Res Treat. 2022;54(4):1065-1073. Published online December 8, 2021; DOI: https://doi.org/10.4143/crt.2021.835

Abstract PDF Supplementary Material PubReader ePub

Purpose
Fear of cancer recurrence (FCR) is a common psychological issue in breast cancer (BC) survivors during early survivorship but whether the same is true among long-term survivors has yet to be empirically evaluated. This study investigated FCR level, its associated factors, and impact on quality of life (QoL) in long-term BC survivors.
Materials and Methods
Participants included women diagnosed with BC between 2004 and 2010 at two tertiary hospitals. Survey was conducted in 2020. The study measured FCR with the Fear of Cancer Recurrence Inventory and other patient-reported outcomes, including depression and cancer-related QoL. Logistic regression was used to identify factors associated with FCR, and structural equation modeling was conducted to explore the impact of FCR on other outcomes.
Results
Of 333 participants, the mean age at diagnosis was 45.5, and 46% experienced FCR. Age at diagnosis ≤ 45 (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.51 to 4.60), shorter time since diagnosis (aOR, 1.75, 95% CI, 1.08 to 2.89), and having a history of recurrence (aOR, 2.56; 95% CI, 1.16 to 5.65) was associated with more FCR. FCR was significantly associated with an increased risk of depression (β=0.471, p < 0.001) and negatively impacted emotional functioning (β=–0.531, p < 0.001). In addition, a higher FCR level may impair overall health-related QoL in long-term BC survivors (β=–0.108, p=0.021).
Conclusion
Ten years after diagnosis, long-term BC survivors still experienced a high level of FCR. Further, the negative impact of FCR on QoL and increased depression risk require an FCR screening and appropriate interventions to enhance long-term BC survivors' QoL.

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Validation of Korean Version of the COmprehensive Score for financial Toxicity (COST) Among Breast Cancer Survivors: Sungkeun Shim, Danbee Kang, Nayeon Kim, Gayeon Han, Jihyun Lim, Hyunsoo Kim, Jeonghyun Park, Mankyung Lee, Jeong Eon Lee, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Jai Min Ryu, Seok Jin Nam, Se Kyung Lee, Juhee Cho; Cancer Res Treat. 2022;54(3):834-841. Published online October 13, 2021; DOI: https://doi.org/10.4143/crt.2021.784

Abstract PDF Supplementary Material PubReader ePub

Purpose
Little is known about the impact of financial toxicity in disease-free breast cancer survivors. We aim to validate the COmprehensive Score for financial Toxicity in Korean (COST-K) and evaluate financial toxicity among disease-free breast cancer survivors.
Materials and Methods
We conducted linguistic validation following a standardized methodology recommended by Functional Assessment of Chronic Illness Therapy multilingual translation (FACITtrans). For psychometric validation, we conducted a cross-sectional survey with 4,297 disease-free breast cancer survivors at a tertiary hospital in Seoul, Korea between November 2018 and April 2019. Survivors were asked to complete the COST-K and European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaires. The test-retest reliability, internal consistency, and validity of the COST-K were assessed using standard scale construction techniques.
Results
The COST-K demonstrated good internal consistency, with a Cronbach’s α of 0.81. The test-retest analysis revealed an intraclass correlation coefficient of 0.78. The COST-K had moderate correlation (r=–0.60) with the financial difficulty item of the EORTC QLQ-C30 and week correlation with the items on acute and chronic symptom burdens (nausea/vomiting, –0.18; constipation, –0.14; diarrhea, –0.14), showing good convergent and divergent validity. The median COST-K was 27 (range, 0 to 44; mean±standard deivation [SD], 27.1±7.5) and about 30% and 5% of cancer survivors experienced mild and severe financial toxicity, respectively. Younger age, lower education, lower household income was associated with higher financial toxicity.
Conclusion
The COST-K is a valid and reliable instrument for measuring financial toxicity in disease-free breast cancer survivors. Considering its impact on the health-related quality of life, more studies need to be conducted to evaluate financial toxicity in cancer survivors and design interventions.

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Financial Toxicity Among Breast Cancer Patients
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Stevanus Pangestu, Fredrick Dermawan Purba, Hari Setyowibowo, Clara Mukuria, Fanni Rencz
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Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China
Yi Kuang, Jiajia Qiu, Ye Liu, Sijin Guo, Ting Chen, Lichen Tang, Winnie K.W. So, Weijie Xing
The Breast.2025; 81: 104441. CrossRef
Cross‐Cultural Validation of the COmprehensive Score for Financial Toxicity (COST) Measure in an Australian Sample
Bora Kim, Claudia Rutherford, Lucy Lehane, Judith Fethney, Louise Acret, Tracy King, Patsy Kenny, Richard De Abreu Lourenco, Kate White
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General

Validation of the Korean Version of the Patient-Reported Outcomes Measurement Information System 29 Profile V2.1 among Cancer Survivors: Danbee Kang, Youngha Kim, Jihyun Lim, Junghee Yoon, Sooyeon Kim, Eunjee Kang, Heesu Nam, Sungkeun Shim, Mangyeong Lee, Haesook Bok, Sang-Won Lee, Soo-Yong Shin, Jin Seok Ahn, Dongryul Oh, Juhee Cho; Cancer Res Treat. 2022;54(1):10-19. Published online April 9, 2021; DOI: https://doi.org/10.4143/crt.2020.1200

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of the study was to validate the Korean version of Patient-Reported Outcomes Measurement Information System 29 Profile v2.1 (K-PROMIS-29 V2.1) among cancer survivors.
Materials and Methods
Participants were recruited from outpatient clinics of the Comprehensive Cancer Center at the Samsung Medical Center in Seoul, South Korea, from September to October 2018. Participants completed a survey questionnaire that included the K-PROMIS-29 V2.1 and the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30). Principal component analysis and confirmatory factor analysis (CFA) and Pearson’s correlations were used to evaluate the reliability and validity of the K-PROMIS-29 V2.1.
Results
The mean age of the study participants was 54.4 years, the mean time since diagnosis was 1.2 (±2.4) years, and 349 (87.3%) completed the entire questionnaire. The Cronbach’s alpha coefficients of the seven domains in the K-PROMIS-29 V2.1 ranged from 0.81 to 0.96, indicating satisfactory internal consistency. In the CFA, the goodness-of-fit indices for the K-PROMIS-29 V2.1 were high (comparative fit index, 0.91 and standardized root-mean-squared residual, 0.06). High to moderate correlations were found between comparable subscales of the K-PROMIS-29 V2.1 and subscales of the EORTC QLQ-C30 (r=0.52-0.73).
Conclusion
The K-PROMIS-29 V2.1 is a reliable and valid measure for assessing the health-related quality of life domains in a cancer population, thus supporting their use in studies and oncology trials.

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Health-Related Quality of Life in Non-Hodgkin Lymphoma Survivors: A Prospective Cohort Study: Danbee Kang, Juhee Cho, Im Ryung Kim, Mi Kyung Kim, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2018;50(4):1051-1063. Published online November 9, 2017; DOI: https://doi.org/10.4143/crt.2017.207

Abstract PDF Supplementary Material PubReader ePub

Purpose
We evaluated health-related quality of life (HRQOL) in long-term survivors of indolent and aggressive non-Hodgkin lymphoma (NHL).
Materials and Methods
TheHRQOLwas assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at diagnosis in NHL patients between 2008 and 2011, and follow-up evaluation was conducted from June 2014 to February 2015 using EORTC QLQ-C30 and the quality of life in cancer survivors (QOL-CS) questionnaire. We used linear mixed models to compare changes in HRQOL between indolent and aggressive NHL over time.
Results
The HRQOL of long-term survivors with aggressive NHL improved to the similar level of indolent NHL during the follow-up survey. However, survivors of NHL were found to fear the probability of relapse and second malignancy, and the degree of fear was not different between survivors with aggressive stage I/II or III/IV NHL (p > 0.05). Furthermore, a half of survivors reported impaired sense of psychosocial well-being regardless of aggressiveness and stage during follow-up survey. More than 65% of survivors thought they did not receive sufficient support from others, and patients who had financial difficulties at diagnosis were more frequently associated with suffering from insufficient support. Impaired physical and cognitive functioning at diagnosis was significantly associated with lack of life purpose in long-term survivors.
Conclusion
The HRQOL of aggressive NHL survivors improved to a similar level to that of indolent NHL. However, the majority of survivors still had fear of relapse, and psychosocial well-being remained unmet needs.

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Validation of the Korean Version of the Quality of Life–Cancer Survivors (QOL-CS-K) Questionnaire in Lymphoma Survivors: Juhee Cho, Danbee Kang, Im Ryung Kim, Won Seog Kim, Betty Ferrell, Seok Jin Kim; Cancer Res Treat. 2018;50(1):204-211. Published online March 30, 2017; DOI: https://doi.org/10.4143/crt.2017.091

Abstract PDF Supplementary Material PubReader ePub

Purpose
The objective of this study was to validate the Korean version of the Quality of Life–Cancer Survivors (QOL-CS-K) in a sample of lymphoma survivors.
Materials and Methods
We conducted a cross-sectional survey of lymphoma survivors who had survived for at least 24 months since diagnosis. Participants were recruited at the outpatient clinics and at a hospital event in a tertiary hospital in Seoul, Korea. Survivors were asked to complete the QOLCS-K and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) questionnaires. To determine test-retest reliability, a second questionnaire was sent to participants who completed the first questionnaire adequately. Exploratory factor analysis and Pearson’s correlations were used for evaluating reliability and validity of the QOL-CS-K.
Results
Among 257 survivors, 245 (95.3%) completed all questionnaires and had no missing data. The mean age of study participants was 52.2 years, 54.9% were men, and the mean time since diagnosis was 4.0±1.6 years. The Cronbach’s α for the overall QOL-CS-K was 0.90, and the α coefficients for each subscale ranged from 0.73 to 0.83. The test and retest reliability was 0.88. Moderate correlations were found between comparable subscales of the QOL-CS-K and subscales of the EORTC QLQ-C30 (r=0.51-0.55) except for the spiritual well-being subscale of the QOL-CS-K, which did not correlate with any of the EORTC QLQ-C30 subscales (–0.08 to 0.16).
Conclusion
The QOL-CS-K is a reliable and valid scale for measuring the QOL in long-term lymphoma survivors.

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